Office for People with Developmental Disabilities
OPWDD
OPWDD PROCESS
Eligibility
● Diagnosis of a developmental disability (speech impediments, learning disability, ADHD and psychiatric disorders do NOT qualify)
● Developmental disability diagnosis manifests itself prior to the age of 22
● It is long-term/permanent
● It is posing substantial adaptive functional deficits
Documentation
● General medical assessment (physical examination form, less than a year from date of exam)
● Psychosocial evaluation/updated social history report (less than a year)
● Psychological/psycho-educational/neuropsychological evaluation report with a developmental background, IQ testing, adaptive behavior scale (either the ABAS-3 or VABS-3)
● For diagnosis other than intellectual disability. A medical or specialty report that includes health status and diagnostic findings to support the qualifying diagnosis, e.g., for autism spectrum disorder either the ADOS-2 or the ADI-R (CARS is not valid).
Process
Process can take about a year to 15 months from the beginning of the process until services launch.
● First step is to call the Front Door unit at the Long Island DDRO who will enter the client into their system and provide them with a TABS number
● Front Door Phone Number: 866-946-9733
● Then, the client should participate in a Front Door information session to learn more about the system.
● Website with dates for Front Door Information Sessions:
● Then, the client should call either a Care Coordination Organization (CCO) or a Non-Medicaid Services Coordinator who will run an intake and a contract has to be signed. Question: what is the difference btw a CCO and a Non Medicaid Service Coordinator
● The NMSC or the CCO intake specialist will help the family gather all necessary documentation and will submit the packet to the eligibility unit.
● Once a notice of decision is made (which takes about 90 days), a letter will be sent to the family.
● The Front Door liaison will conduct a DDP-2 (developmental disability profile) assessment over the phone, and will schedule either a CAS or a CNS assessment.
● When that is accomplished, the liaison will issue a level of care form to the CCO or NMSC, and they will start working on submitting the HCBS Waiver application to the waiver unit.
● If the waiver is approved, the CCO (but then the client is assigned with a care manager), or the NMSC will submit the Medicaid application.
● When approved, the client can’t keep working with a NMSC only with the CCO. They will now have to choose a traditional service model, or a self-direction model.
● If Self-direction, they will have to find a family support broker and a fiscal intermediary who will process reimbursements for services and will hire and pay staff for the client.
Family Support Services
● Family reimbursement (up to $1000 a year)
● School recess respite program
● Afterschool programs
● End of summer respite program
● Behavior management
● Short-term skills training
● Parent training
● Crisis intervention
Medicaid Waiver Services
● Community habilitation
● Respite
● Day Habilitation
● Supportive employment
● Individualized Residential Alternatives (IRAs)
● Self-direction service modality (for families who are looking for more inclusive settings/opportunities)
● NYSTART/CSIDD (for behavior management and support)